The Argument for Mandatory Vaccines

Disease borne from viruses, bacteria, and even parasites have long been the bane of human existence, causing millions of deaths each year and significantly impairing human productivity and livelihood. As our scientific understanding of diseases and the immune system has advanced, we as a society have uncovered new ways to exploit natural immune system defenses to protect ourselves from the diseases that once rampantly destroyed our population. These advances arrive primarily in the form of vaccines, which represent one of the most fundamentally powerful advances in human scientific understanding and technology in the last century. Vaccines have allowed us to eradicate multiple diseases completely, preventing them from infecting any living creature on the face of the Earth – a remarkable achievement – and have allowed us to bring many more once widely prevalent diseases to heel, greatly constraining their impact. Unfortunately, a recent trend over the last 1-2 decades in the USA is actively working to undermine these vaccine-borne advances in the form of the so called “anti vax” movement, which seeks to prevent the vaccination of children that would otherwise protect them from infection. This movement is dangerous both to the affected children and those around them, and as such it is crucial that the United States adopt a more rigorous plan of mandatory vaccinations for children, rather than leaving it as a matter of some personal choice. Choice is important in many aspects of our lives, but in the case of vaccines the benefits to mandatory vaccination greatly outweigh the negatives.

The Modern Vaccine Era

The first official “vaccine” involved the inoculation of individuals with cowpox, a virus closely related to the far more dangerous smallpox virus. When people became infected with cowpox, they developed an immune response that also protected them against the ravages of infection with smallpox. While the identification of the vaccination capabilities of cowpox was a victory for society and undoubtedly saved millions of lives, the lack of any understanding of why the vaccine was working prevented and substantial empirical advances for vaccines against other diseases for the next 150 years. With time, however, scientists came to recognize that bacteria and viruses were the cause of disease, and the body has immune cells which are able to defend against disease. They further observed that the human body is able to rapidly destroy any bacteria or virus which it has successfully defeated in the past, giving rise to the notion of protective immunity. When this paradigm was extended to vaccine development, the way ahead became clear – it was necessary to develop vaccines that tricked the human body into believing it was infected with a particular pathogen without causing a full blown case of disease, much as occurred with the cowpox infections that gave rise to the initial observations supporting this theory.

The first successful scientifically developed vaccine was the polio vaccine developed in the middle of the 20th century. Jonas Salk and other scientists essentially created a weakened version of the polio virus using various microbiological and chemical interventions in their laboratories. They found that when they injected this virus into people, the body would recognize the disease as a threat and defeat it but the inoculated individual would only experience mild side effects rather than paralytic polio disease (provided the individual had a functional immune system, which is essential for the development of such responses). When this vaccine was introduced to the public it quickly led to a decline in the frequency of poliomyelitis in the world, reducing the consequent mortality and eliminating the need for facilities filled with iron lung machines that enabled children whose diaphragms had been paralyzed by polio infection to continue to breath.

This initial vaccine is not without its risks; specifically, it causes inoculated individuals to shed live virus particles which are harmless to those with strong immune systems, but which can cause somewhat dangerous cases of vaccine acquired polio in the elderly or those with genetic defects in their immune systems that prevent normal functionality. Initially this risk was not obvious, and it is believed to be far less of a risk than allowing the full fledged polio virus to continue to circulate throughout the world, thus again allowing a vaccine with some risks to triumph over the incredible dangers of having no available recourse against disease. Indeed, in theory if all individuals in a society are protected against polio then there is no risk from vaccine acquired polio, and it is only when there is a breakdown in vaccination efforts that this weakened virus is able to damage susceptible individuals. In time, a new polio vaccine that did not use any live virus and cannot cause vaccine acquired poliomyelitis was developed thereby reducing the risk imposed by vaccination. Even so, this vaccine is more expensive and less effective than the original vaccine, meaning that many of the ongoing efforts to eliminate polio rely on the vaccine which must inherently impose some small risk to individuals for the benefit of humanity as a whole.

After the development of the polio vaccine and modern vaccine theory, there was an increased rate of production of new vaccines against the diseases that were most often associated with human death and misery. Over time, vaccines against a number of childhood diseases such as measles, mumps, rubella, and chicken pox were all developed and have become standard childhood innoculations. Similarly, tetanus, hepatitis, HPV, and many other diseases can now be treated with one or a few relatively infrequent vaccine sessions, thereby preventing disease and consequent misery.

Societal Benefits

Vaccine preventable illnesses used to cause millions of deaths and billions in lost wages and other reductions in income as an effect of a parent or a child falling ill with a pernicious infection. Since the advent of vaccines, suffering that was once commonplace has become distant and is little more than a memory for many living in the modern Westernized world. The days of city wide quarantine efforts and the threat of outbursts of plague are far less prevalent than they once were, although the risks posed to society by infectious diseases will never be completely abated and requires constant vigilance to maintain.

The greatest victory a vaccine effort can hope to achieve is the complete elimination of the disease from the world. This goal is quite difficult to obtain for a number of practical and logistical reasons. For one, many diseases that cause lethal infections in humans are able to survive in other species without causing any discernible disease. In the case of these zoonotic infections, human disease only arises because the virus treats human cells as though they were the cells of its normal host species and the human cells are not able to compensate for viral activity as well as those of its host, resulting in cell death and severe symptoms. Indeed, emerging diseases in the modern era are usually identified as being newly acquired zoonotic infections, such as the recent SARS outbreak which was determined to be derived from a virus that primarily infects bats without incident but that caused severe respiratory distress when it made its way into the strange environment of the human lung where the bats’ defense mechanisms no longer constrained its growth. If a given virus could be eliminated in the human population but would forever be present in an animal population that would serve as a disease reservoir, then there would never be any true eradication of the disease and the threat of its re-emergence would be persistent. This would thereby require indefinite vaccination programs in order to maintain the control of the virus.

In addition to this challenge, many diseases do not provide life long protection against further infection even when the individual has been infected with a full strength strain of the disease. These diseases are often able to avoid such protection due to their frequent changing of their surface protein structures, which are what the immune system relies upon to recognize a compound as being a foreign body that needs to be targeted for elimination. Diseases that do this, such as malaria or HIV, provide a unique challenge for scientists aiming to design a vaccine because the human body is not able to promote any sort of vaccine like protection, thus dampening hopes of producing such vaccines in the lab. This is not to say that these efforts are hopeless, and there are frequent advances being made to this field that exploit new knowledge of the immune system’s inner workings with the hope of allowing for the development of life long immunity against diseases where no such immunity has previously been known to exist.

Despite these hurdles to vaccine development, there have been two successful cases of diseases having been eradicated in the wild – the infamous smallpox, and the less well known Rinderpest. The elimination of smallpox was no small feat and it required a level of international coordination and cooperation that was heretofore unfathomable. The World Health Organization (WHO) was able to lead the campaign against smallpox, providing vaccina innoculations throughout the world. Smallpox fulfilled the rare requirement of being a disease that uniquely infects humans, likely because the ancestral species from which the virus initially arose is no longer alive or is no longer susceptible to infection. Furthermore, smallpox protection is life long. These two factors ensured that if smallpox were to be eliminated then it would remain eliminated, barring any deliberate re-introduction of the disease into human society as by an act of bio-terrorism or a spontaneous development of a comparable infection. This, coupled with the fact that smallpox was a very lethal disease that was responsible for untold levels of mortality over the course of human history made it a clear first candidate for the WHO viral eradication efforts.

Smallpox was eradicated in the 1970’s to much celebration, as the process was no small feat. The details of eradication are beyond the scope of this essay, but were complex and required rapid responses to disease outbreaks that were nontrivial to implement. Following its eradication and the unfortunate death of a medical researcher from a case of lab acquired smallpox, the smallpox virus was frozen away in two labs in the world (one in the USA and one in Russia) and it has not been seen in the wild since. Rinderpest was a far more obscure disease to the average person, as it was a livestock disease affecting cattle and was thus not as infamous as smallpox. Nonetheless, efforts to eliminate Rinderpest were very recently successful and as a consequence this pestilence which had often destroyed herds of cattle has too been eliminated.

Vaccine Opposition Movements

While it is undeniable that vaccines have provided a means to promote human longevity and eliminate suffering, there are increasing efforts to prevent further vaccination programs. These efforts do not come from any single source, and thus it is perhaps important to consider that many groups have many unique reasons for opposing vaccination and different approaches are likely needed to combat these myriad concerns and to thereby allow for the continued advancement of society.

Scientific Fraud and Autism Fears

The most prominent threat to modern vaccination efforts in the Western world was born out of a fraudulent study conducted by the doctor Andrew Wakefield. In his study, Wakefield manipulated data he collected from a small group of children in such a way that he was able to wrongly conclude that these children suffering from autism may have developed autism after they received the measles mumps & rubella childhood vaccine possibly due to mercury or other preservatives in the vaccine. This study when it first came out was published in a prestigious journal and immediately generated fears that vaccines were causing a debilitating disease in children, prompting cries for the elimination of further vaccine efforts from concerned parents and celebrities.

Over time it became clear that Wakefield had falsified his data and was in fact having his research funded by people that wanted to create a lawsuit against the very company that makes the MMR vaccine, creating a clear conflict of interest that readily explains this corruption of science. Indeed, over 200 peer reviewed studies have since studied the link between vaccines and autism and every one of them has found the link between the two to be nonexistent. In this way the science was able to bounce back from this instance of fraud, however public perception was far more damaged and has not restored the full faith that science puts in these important childhood vaccines.

Much of the anti-vax movement has grown out of the fear and misinformation being presented to the public with regard to the risks of vaccines and autism in children. Indeed, the majority of people who choose to not vaccinate their children are scared parents that buy into the claims that they will give their children autism. In this sense the fear is easy to understand and empathize with, however it is not excusable as if one were to fully investigate the risks of vaccines they would see that they are negligible compared to the risks posed by the diseases they prevent (not to mention that none of those risks incorporate autism or autism spectrum disorders). Many of these parents buy into the hype out of confusion and falsified claims from specious sources – indeed, many companies which provide “alternative” treatments for autism or similar services will claim that vaccines are a scam and that there is a conspiracy to prevent the public from discovering the true risks inherent in these medical devices. These companies are inevitably motivated by profit, with the invisible hand swatting away any ethical concerns they might have leading them to present a fallacious front that confused parents may occasionally buy in to.

At the forefront of this anti-vax movement are various celebrities of specious expertise, with former playboy playmate and news anchor Jenny McCarthy being foremost among them. McCarthy is an ardent supporter of Andrew Wakefield and believes that vaccines cause autism, a disease from which her young son is known to suffer. Accordingly McCarthy frequently campaigns for the elimination of childhood vaccination programs and stresses the importance of avoiding “poisoning” children or “overloading their immune system”, which are common nonsensical concerns raised regarding vaccination. McCarthy has been much maligned for her support of the anti-vax movement, though website such as the “Jenny McCarthy body count” that tallies the total number of cases of vaccine-preventable death and illness since McCarthy began her campaign may be a bit excessive and lay too much blame at the feet of one mere facet of the anti-vax industry.

While this modern anti-vax movement is led by celebrities and supported by parents concerned about the dangers which modern life may impose on their precious and vulnerable offspring, its true victims are children. For one, children that do not receive childhood vaccines will inevitably be susceptible to these diseases later in life, and many diseases such as mumps are more likely to cause dangerous complications in older individuals causing these kids to be at an increased level of risk each day. In addition, other children whose parents are unable to vaccinate them are also placed at risk. To understand this concept, one must understand the immunological concept of “herd immunity”. Essentially, if a given number of people are vaccinated against a disease, say ~90%, then if one unvaccinated person contracts the disease, 90% of the people they encounter will not be able to get the disease, and thus it is likely that the disease will not spread to anyone else, thus protecting the remaining 10% from getting the disease. If the anti-vax movement were to succeed then the number of people vaccinated against a disease may begin to decline, thereby compromising herd immunity and endangering those that cannot be vaccinated for legitimate medical reasons such as allergy or immune system compromise.

In a sense, due to the hurdle of herd immunity, the choice to vaccinate ones children is not a personal choice which will only effect that family, but rather it is a choice that has profound implications for public health. One might argue that parents have a duty to society to vaccinate their children if able, as this is the only way to maintain herd immunity and provide the protection guaranteed by vaccines to all that may benefit from them.

The concerns currently raised by this modern anti-vax movement do not hold up to scientific scrutiny and instead rely on fear and misinformation, much as in the case of Jenner’s backlash experienced centuries ago. It is unsurprising that resistance to vaccination arises from these efforts, as no parent wants to think of themselves as being the cause of some childhood trauma or debilitating mental condition in their child. It is essential that going forward, however, efforts are consistently made to eliminate these fears and restore public confidence in vaccines by not giving celebrities a soapbox to rant from not giving companies an audience that they may exploit for their own profit at the cost of human health.

Religion and Espionage

In the USA and other parts of the Western world, it is this mixture of misinformation and fear that drives the anti-vax efforts, however in other parts of the world the landscape is entirely different and requires a different approach to bring about change. Specifically, religious extremism mingles with national politics and creates a unique brand of individuals that will militaristically impose an anti-vax regimen out of distrust for those providing the vaccines.

Efforts to make polio the next human disease that is eradicated in the wild have been underway ever since the vaccine’s inception, and there has been great progress made in the past 65 years. Polio is another virus that manages to meet the abovementioned criteria that make it an ideal target for elimination, prompting another WHO effort to that effect. Indeed, in 2012 there were less than 300 cases of wild polio virus in the entire world, mostly concentrated in a few select countries (Chad, Nigeria, Pakistan). India, a country once thought to be impossible to free from polio’s paralytic grasp, was declared polio free in 2013 due to a combination of improved public health awareness, sanitation, and most importantly rigorous vaccination. The Western world has been polio free for decades and the disease is often viewed as all but eliminated. Unfortunately, in 2013 there was an increase in the total number of polio cases in Nigeria and Pakistan due to an anti-vax movement which is gaining increasing momentum due to its military support and imposition.

Fears of US jingoism are often intertwined with the fact that many WHO vaccinators come from Western nations as do the vaccines they provide, prompting a range of claims with regard to the nefarious purposes of these vaccines. Indeed, there have been claims that these vaccines are intended to poison the recipients or even to make them more susceptible to control by the Western powers that would wantonly impose their imperialistic will on the suppressed populace. While such claims are abjectly false, there have been decisions made on the part of the USA which have permanently endangered the polio vaccination effort as well as the lives of those that run the vaccine campaigns in unstable nations, particularly Nigeria, Afghanistan, and Pakistan.

In the hunt for Osama Bin Laden, an effort which the US government viewed as paramount as an aspect of the ongoing war on terror in Afghanistan, the CIA employed various clandestine maneuvers to gain information leading to the Bin Laden compound. One ruse that they utilized was that of posing as WHO vaccinators, which allowed members of the CIA to collect DNA samples from those they injected with polio vaccines. These samples allowed them to identify an individual known to be a courier for the Bin Laden family, and this identification eventually led to his capture and Bin Laden’s ultimate demise in Pakistan. Eventually the details of this clandestine disguise came to light, leading to a profound mistrust of those purporting to be vaccinators.

As a result of this selfish CIA cover story, polio cases have risen in Pakistan and Afghanistan since the death of Bin Laden, as the number of people being vaccinated has decreased. The Taliban and other militant war lords have declared a ban on vaccinations among their constituents amid fears that any vaccinators cannot be trusted and may be working at the behest of the US or its allies to collect information and/or kill targeted individuals. Since this ban went into effect, in addition to the rise in polio cases there have been several vaccinators who have been shot to death despite their lack of affiliation with any organization that intended to do anything other than prevent the outbreak of deadly diseases with the ultimate goal of eliminating them from the world.

Unfortunately, there is little immediate recourse to mend the irreparable damage inflicted by the CIA on the world effort to eliminate polio and banish it to the freezers of advanced research facilities much like smallpox. Efforts to educate the public in these areas may help to increase understanding of the importance of vaccination, however it is likely that fear of either the US or of violent retribution will be sufficient to keep thousands of at risk individuals from receiving much needed injections. In time, changes in US foreign policy and regional politics may help to smooth over fears and reinstitute the vaccination programs, but for now this militant anti-vax movement persists at the cost of human lives. In effect the US government was willing to compromise world health efforts as part of a political agenda, and the damage has been done.

The Case for Mandatory Vaccination

In the United States, children are required to receive a number of vaccines before they are able to attend public schools (and in many cases private institutions as well). Required vaccines include the MMR (measles, mumps, and rubella) vaccine that was at the heart of the fallacious autism scare, as well as vaccines for many other formerly common and/or insidious diseases such as polio, chicken pox, and tetanus. School represents the first time that many of these children will congregate in one place for an extended period of time, allowing them to more readily spread contagious diseases between one another. These vaccines ensure that such spreading does not occur at any appreciable rate by protecting these children from ever acquiring the infection. Through the previously discussed mechanism of herd immunity, requiring vaccinations will also protect individuals that have not been vaccinated so long as the percentage of people receiving the vaccines is sufficiently high.

In the current set up in the USA, while children are technically required to receive these childhood vaccines, there are many exceptions that can be granted to make them exempt from such requirements. Religious exemptions are one category of exemption that prevent students from requiring vaccines if they allegedly interfere with the tenants of their faith. In addition, students may avoid vaccination if their parents find a physician willing to effectively sign a medical exemption form stating that in the physician’s opinion the student need not receive the vaccine for any number of personal or medical reasons. While in certain cases these medical exemptions are necessary – for example, some children may have actual dangerous allergies to the vaccines, or may have weakened immune systems that would make such vaccines legitimately dangerous – in most cases this system is abused by the anti vax movement to prevent their children from receiving the vaccines that they wish to avoid. Indeed in certain parts of the US (particularly in Southern California), certain pediatricians make all of their business from advertising themselves as anti vax doctors willing to sign such exemptions for their patients in return for monetary compensation.

This anti vax movement is steadily eroding away the foundations of the herd immunity effort, as evidenced by a recent Measles outbreak that began in Disneyland in California, near the heart of the anti vax territory, before spreading throughout the country. Only by mandating vaccines for all children will we be able to restore herd immunity, thus protecting those who are at risk of serious infection with these pathogens such as the very old, or those who truly need exemptions from vaccination due to legitimate medical concerns.


As is immediately clear, the efforts to cure human disease through vaccination efforts have been remarkably successful on the whole, saving thousands if not millions of lives and preventing billions of cases of diseases which would have negatively impacted society. While it is true that vaccines alone are not to blame for the decrease in disease rates (sanitation is another major reason, although antibiotics have aided in the effort), their impact was rapid and profound. In time is likely that humanity will be able to eliminate other diseases from the world, with polio being the first to go, however the anti-vax roadblocks will not be trivial to overcome.

With every new innovation inevitably comes mistrust and fear that it will somehow disrupt the fabric of society or harm individuals irreparably. This same fear has manifested in response to Jenner’s cowpox vaccine efforts and in many of those participating in the anti-vax movement in the modern Western world. Only by promoting education efforts and censuring those that voluntarily avoid being vaccinated can we as a society move towards assuring herd immunity and maintaining appropriate defenses against outbreaks of whooping cough or other debilitating diseases. There is no reason for anyone to suffer from preventable diseases in this age of globalization, and it is essential that we overcome the fear that holds individuals back from these vaccinations. Whether this fear comes from claims of autism, militant threats, or other sources, it is up to individuals and governments to work together to mandate vaccination and thereby save the lives of millions who have not yet been born but who will inevitably be put at risk if nothing is done.


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